There are numerous CBT and the adapted DBT mindfulness techniques that can be improve one's ability and skill to tolerate distress. One amongst the methods that I like uses our power of imagination creatively to reduce distress and associated behaviours. When practiced and after knowing what works for you thought diffusion as a method will mitigate against self harm episodes by allowing you to de-link thoughts, emotions and behaviours from one other, simply observe them and allow them to pass. 

Thought Diffusion exercise (click here for video's): 

  1. Practice this when not distressed with neutral thoughts, and feelings so it is easier to apply the technique during distress. 
  2. Use this when you start to notice you are getting upset and your mind is flooded with negative thoughts / feelings / urges to act out on impulses such as self harm, cutting, burning, hate, anger, need to punish, internal punitive voices like loser, stupid.........
  3. Close your eyes if needed. Imagine the above as labels or tags, attach them to an object and imagine this object disappear, dissolve, disintegrate.....with it the label and tag as well leaves reducing the negative clutter and chatter in your head. 
  4. Here are some examples - 
    • Imagine distressful words tagged to cumulus clouds that are blown away by wind. 
    • Negative feelings / thoughts / urges sat on petals of a flower blown away by the wind. 
    • Imagine you have scribbled 'hate, cut, razor blade.....on sand and a wave washes the thoughts and associated feelings away. 
    • Pop some balloons in your minds eye or for real, imagine writing the negative labels on the balloon and then pop them / explode them. 
    • Make a paper boat or rocket, label them with the troubling words and see them either go down a stream of water or fly in to outer space. 
    • Words can fly - anything goes in your minds eye, so imagine them go father away, as they do, they reduce in size and so does the associated emotion, let them fly away to their oblivion. 
    • Put the words on a paper, tear it / crumple it and bin it. 

Find out what works for you, each person is unique. To get started, or to run over this technique with younger kids watch these video demonstrations

Dr A Joglekar